Preëxisting Women

A provision of the health-care bill that’s gotten less attention than some, but is pretty big: At the White House blog, Lynn Rosenthal, the President’s adviser on violence against women, notes that victims of domestic violence need health care and that women “need to be able to talk to their health care provider about the cause of their injuries without fear of losing their health insurance.” Didn’t we know that? Apparently not: > Yet until last night, insurance companies in eight states and the District of Columbia could still discriminate against victims by declaring domestic violence a preexisting condition. Domestic violence victims in those states faced the real risk of being denied health care at the very time when they needed it the most.

Just when you thought you had your mind around how bad our current system is, you read something like that. You’re denied health coverage for being in (or trying to leave, or having left) a bad relationship? Among all the other things a woman in that situation has to fear, she has to worry that if she told her doctor where she got those bruises she might lose her health insurance? How about her children’s insurance, as that is often tied to that of the parents? What if a woman who was battered had cancer—would she have to choose between seeking help for one problem or dying of the other? (Or dying of both—Rosenthal notes that domestic violence causes twelve hundred deaths a year, and two million injuries.) And, if she did make some excuse for her injuries, could whoever caused them use that against her if she went to court? During the final debate on the bill, Congresswoman Lynn Woolsey, noting that prior pregnancies and Cesarean sections “and most unbelievable of all” domestic violence could be considered preëxisting conditions, said, “We should all be ashamed.”

The bill should change this, which is more than good. (It’s not clear that the fix will be instant; exclusions for preëxisting conditions are set to end in 2014, although in the interim insurance should be available through a high-risk pool.) Despite the regrets about public options, the bill is sounding better all the time.